Cavitary Legionellosis in Two Immunocompetent Infants

Famiglietti, Ronald F.; Bakerman, Paul R.; Saubolle, Michael A.; Rudinsky, Mark F.

doi:10.1542/peds.99.6.899

Cited by 17 publications

(4 citation statements)

References 22 publications

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“…clarithromycin) have proven to be as effective as erythromycin, with the added benefit of fewer side effects [6]. Steroid application may be required as additional therapy if oxygen requirement is high [5].…”

Section: Discussionmentioning

confidence: 99%

Legionella waltersii —a novel cause of pneumonia?

König¹,

Hebestreit²,

Valenza³

et al. 2005

Acta Paediatrica

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Section: Discussionmentioning

confidence: 99%

Legionella waltersii —a novel cause of pneumonia?

König¹,

Hebestreit²,

Valenza³

et al. 2005

Acta Paediatrica

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“…Cavitary lesions in Legionella pneumonia have been described in infants [ 7 , 8 ], in renal transplant patients [ 6 ], in adults with inflammatory/autoimmune diseases on immunosuppressive therapy [ 9 ], and in patients with primary immune disorders [ 10 ]. While immunosuppression appears to be an important component of the ability of Legionella to create extensive disease significant enough to cavitate, it is the suppression or depression of the acquired immune system and specifically defense against intracellular pathogens that is likely the key permissive factor.…”

Section: Discussionmentioning

confidence: 99%

Cavitary Legionella Pneumonia in AIDS: When Intracellular Immunity Failure Leads to Rapid Intrapulmonary Cavitation

Durrance

Min

Fabbri

et al. 2021

Case Reports in Pulmonology

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Introduction. Legionella is a frequent cause of bacterial pneumonia in patients with AIDS. While multiple organisms have been associated with cavitary pneumonia in this population, Legionella has not. Clinical Case. A middle-aged woman with HIV-AIDS and severely depressed CD-4 count presented with one month of progressively worsening productive cough and dyspnea. Serial imaging showed focal consolidations which multiplied and cavitated over the subsequent days. Legionella urine antigen was positive, and appropriate treatment was continued for 3 weeks total. The patient recovered quickly, and follow-up imaging 8 weeks later showed near-resolution of all lesions. Discussion. Cavitary pneumonia secondary to Legionella has been seldom described, traditionally in the context of immunosuppressive therapy. Patients with AIDS and severely depressed CD4 counts have significantly compromised cell-mediated immunity. This case highlights the importance of consideration for legionellosis in rapidly progressing cavitary pneumonia, especially in patients with severely compromised cell-mediated immunity, including those with HIV-AIDS.

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“…8e12 It has been described in infancy 13 and early childhood. 14 In immunocompromised patients cavitation may become fairly common, establishing difficulty in differential diagnosis for pathogens causing cavitary necrosis such as mycobacteria, fungi, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella and anaerobes.…”

Section: Discussionmentioning

confidence: 99%